It has been often
alleged that women were shortchanged by medical research. For example, a 1993
editorial in The New England Journal of Medicine made this categorical
assertion: "There is little doubt that women have been systematically
excluded as subjects for study . . . it is not surprising that most clinical
trials have been heavily, if not exclusively, weighted toward men" (1). A
1999 fact sheet from the National Institute of Mental Health stated,
"Historically, research studies were conducted only with men."

It is now clear that the
claim of the routine exclusion of women is not consistent with the facts: • As
early as 1979, women participated in 96% of all clinical trials sponsored by the
NIH (2). • An analysis of enrollees in one of the major trials sponsored by
the National Cancer Institute found that women represented 57% of all
participants in 1989 (3). • Meinert and colleagues reviewed all clinical
trials published in five leading medical journals in the years 1985, 1990, and
1995. Overall, there were 550,743 women and 355,624 men enrolled in these trials
(4).

An article that appears
in the September 2001 issue of Epidemiology gives further evidence of
sex-specific participation in clinical trials (5). I did a Medline search for
clinical trials published in the period 1966-1990, identifying the number of
sex-specific "hits" for each of 12 important health conditions:

It can be seen that a
similar number of clinical trials on arthritis, COPD, injuries, mental health,
and stroke included men and women. In the areas of AIDS, diabetes, heart
disease, and flu, more trials included men. And in the areas of cancer,
reproduction, and sex hormones, more studies included women. Overall, the total
number of clinical trials favored women by a 26.5% margin.

Although it appears that
women were underrepresented in heart disease research (6), it is clear that men
were underrepresented in other important areas of medical research.

The perception that
women were commonly excluded from medical research, and the belief that health
research needed to play "catch-up" for this fact, has formed the basis
for much of gender health policy over the past decade. The number of female-only
studies grew to outpace the number of male-only studies by a three to one margin
in 1997 (7). Asa result, overall male participation in NIH extramural research
fell to only 32.2% in 1997 (8).

If we are going to play
"catch-up" in the area of heart disease research for women, why aren't
we helping men's health research compensate for past underrepresentation in the
areas of cancer, reproduction, and sex hormones?

[Links: The New England
Journal of Medicine http://content.nejm.org/ The Journal of the American Medical
Association http://jama.ama-assn.org/ The National Institute of Health http://www.nih.gov/
The National Institute of Mental Health http://www.nimh.nih.gov/ The General
Accounting Office http://www.gao.gov/ Epidemiology http://www.epidem.com/ ]